CLINICAL STUDIES ON ETIOPATHOLOGY AND MEDICO SURGICAL MANAGEMENT OF RECURRENT GENITAL PROLAPSE IN COWS
dc.contributor.advisor | TANK, P. H. | |
dc.contributor.author | BADGUJAR, CHANDRAVADAN LAXMAN | |
dc.date.accessioned | 2018-06-19T04:22:16Z | |
dc.date.available | 2018-06-19T04:22:16Z | |
dc.date.issued | 2011 | |
dc.description.abstract | Incidences of pertparturient cervico-vaginal prolapse (CVP) have been recorded in dairy cows all over the world by many workers. However, rarely there has been a mention of cases of chronic prolapse occurring beyond three months of parturition. On the contrary, it was experienced to be occurring in high number in the Gaushalas and Panjarapoles of Gujarat. A majority of the affected cows were from Gir or Kankrej breeds and their crosses. They had suffered repeated episodes of the problem. Conventional methods of treatment were unsuccessful to address this problem. Hence, a clinical study was undertaken to evaluate various aspects of CVP including medicosurgical management by different approaches in 46 cows of Gaushalas and Panjarapoles in Saurashtra region of Gujarat. A novel method of 100 point score for each character was evolved to assess the health of cow and severity of prolapse. The cows that fell in the range of aggregate points between 0-25, were graded as Grade-I; between 26-50, graded as Grade-II; between 51-75, graded as Grade-Ill, and cows with score from 75-100, were graded as Grade-IV. None of the cases under study fall in the Grade I category. The cases of Grade-II were subjected to surgical treatment utilizing Technique No. 1 (Fixation to prepubic tendon) or No. 2 (Button suture fixation). Cases falling under the Grade-Ill were treated with the use of surgical Technique No. 3 (Amputation of prolapsed mass) or No. 4 (Submucosal resection of vagina). In cases of Grade-Ill, the cows that had irreducible adhesions of the prolapsed mass or abnormalities of os cervix in the form of kinked, hardened, fibrosed or extensive enlarged cervix were subjected to Technique No. 3 (Amputation of prolapsed mass). Cases of Grade-III that had less changes of the os cervix as mentioned but had more of vaginal proliferation and fibrosis were subjected to Technique No. 4 (Submucosal resection of vagina). The cases of Grade-IV were put to treatment by Technique No. 5 (Pervaginum Panhysterectomy). These cases were advanced, unmanageable, highly suffering and with non-viable appearance of prolapse. Those cows which showed ovarian abnormalities were subjected to Technique No. 6 (Pervaginum Bilateral ovariectomy). They came in Grade II prolapse. After supportive therapy, anaesthesia was performed in the form of caudal epidural analgesia and pudendal nerve block under xylazine sedation. Appropriate surgical treatment was applied to each cow. The 46 affected cows were grouped as per the surgical technique provided from Group 1 to VI. In Group I to V, eight cases were operated, while in Group VI, six cases were operated. In addition to this, blood and serum samples were collected for comparison, from eight healthy lactating normal cows as a control group. For fixation of vagina to prepubic tendon, insertion of the needle in the prepubic tendon required lot of skill to retrieve the needle back between the main and lateral branch of the prepubic tendon. Although this technique appeared very promising, the entire procedure was to be performed blindly only by palpation in the cul-de-sac of vagina. In view of a limited bite in tlie vaginal floor and the prepubic tendon, the chances of rupture of the suture or the tearing of the vaginal wall could not be overlooked. Considering the complexity in execution, this technique is recommended only in the hands of an experienced worker. Button suture fixation was used on 8 cows. Commercially available suture needle (triangular and straight needle No.l) worked satisfactorily to put these sutures. Since the vaginal insertion of the suture was preplaced on the prolapsed mass, there was adequate visibility and a very little haemorrhage occurred in the placement of the suture. Amputation of prolapsed mass was easy in this technique as the entire mass was presented at the vulva for handling. However, due to the large size and irreparable changes in the vagina and the cervix, the wall of the organ was considerably thick making it difficult to cut. Submucosal resection of vagina was fairly simple than amputation. As the surgical dissection was restricted only to the submucosa of the exposed portion, haemorrhage from the dissection was comparatively less. Since the technique did not involve extensive dissection or ligation of blood vessels, the procedure could be completed in comparatively lesser time. In cases of per vaginum panhysterectomy, the dorsal wall of the vagina bled considerably. Further dissection for the uterine junction and ovarian stumps had to be done blindly by palpation with fingers. It was felt necessary to put two ligatures on the stump to ensure complete obliteration of the ovarian blood vessels. After having completed this procedure, small length of vagina was left behind so that there was no chance of recurrence of prolapse. Per vaginum bilateral ovariectomy was performed in the similar manner as in pervaginum panhysterectomy. The uterus and cervix were left intact. For performing the ovariectomy, a specially designed Richards' ovariotome was used to crush the ovarian blood vessels and to cut the pedicle. Suturing of the vaginal incision (colpotomy) did not pose major problem and the entire surgery could be completed in 20 to 30 minutes. In Group 1 and II, recurrence of prolapse was noted in one cow each due to rupture of sutures. In one more case of group II, pyometra was noted due to foreign body i.e. buttons. In Group III, all the animals showed mild to moderate bleeding from vagina .and mild straining. This was treated by local infusion of Betadine solution and application of Ceftriaxone powder. This bleeding disappeared towards 7-8 days and effectively stopped at 10 days. One cow showed recurrence of prolapse. In Group IV, minor haemorrhage through vagina was noted in all the cases for 1 or 2 post-operative days. All the animals recovered uneventfully, except one cow that suffered prolapse at 24th post-operative day. In Group V, all the animals, except one cow, showed slight haemorrhage for a period of 3 to 4 days followed by slight mucous discharge for next 3 to 4 days, but recovered uneventfully by 15 days. Prepubic tendon fixation and Button suture fixation were performed in those cows where the prolapse was mild to moderate type (Grade II) with no complications like oedema, necrosis, gangrene and other secondary complications like maggots infestation. As such these two techniques were useful in conserving the genitalia. However, button suture fixation method was preferred to address the clinical condition. Two cows treated with button fixation technique conceived subsequently. Thus, these animals would have become useful for reproduction in future. Submucmosal resection was comparatively easier to perform and resulted into less serious haemorrhage. In those cases where the changes in the prolapsed organ appeared irreversible, it was decided to remove entire reproductive tract per vaginum (Panhysterectomy). This surgical technique also was quite demanding owing to large number of engorged blood vessels in the dissection. Per vaginum bilateral ovariectomy was reserved for those cases where ovarian changes were marked. It was postulated that the prolapse was primarily due to ovarian dysfunction. This was proved when the ovariectomy was performed and the prolapse was repositioned. No recurrence was noted in any of the six cases until eight days. However, this procedure was performed in ox cases and only had moderate Grade II prolapse. Therefore it requires further study. Haemato-biochemical and serum endocrinological assessment paved a clinical way of understanding the etiopathology, stress and therapeutic resolution of this complex malady in cows by contemplating the findings to the clinical merits of the cases retrospectively. Various micro organisms were isolated from the vaginal swabs from these cows. Antibiotic sensitivity test indicated that Ceftriaxone and Enrofloxacin were both effective against these organisms while Amoxirum was not as effective. Urinalysis can be used as one indictor to assess pre-operative status and effect of surgical treatment. Histopathological studies of genital tissue on surgical removal in Group I and II, did not show significant lesions while Group III, IV and V cases revealed, variable degrees of inflammatory lesions, characterized by degeneration, edema necrosis and fibrosis. Moderate to severe infiltration of mononuclear cells in the vaginal and cervical mucosa were found in groups III and IV. Group V indicated necrosis of superficial mucosal lining with the presence of bacterial colonies. Hyperplasia of glands of vaginal and cervical mucosa showed neutrophils and mononuclear cells infiltration with cystic dilatation. The group V cases revealed chronic inflammatory changes of adhesions, lacerations, necrosis and perivascular fibrosis, hyperplasia of uterine glands along with congestion and haemorrhage. The group VI cases, (with abnormalities of ovaries) revealed cystic dilation with fluid filled cavity, with single layered cysts. Few specimens revealed multicystic ovaries which had thick, multilayered wall and cyst within the wall. The histological signs correlated with the clinical signs and helped in prognosis of repair and cure of the case. | en_US |
dc.identifier.uri | http://krishikosh.egranth.ac.in/handle/1/5810053999 | |
dc.keywords | CLINICAL STUDIES ON ETIOPATHOLOGY, MEDICO SURGICAL MANAGEMENT, RECURRENT GENITAL PROLAPSE IN COWS | en_US |
dc.language.iso | en | en_US |
dc.publisher | AAU, Anand | en_US |
dc.research.problem | CLINICAL STUDIES ON ETIOPATHOLOGY AND MEDICO SURGICAL MANAGEMENT OF RECURRENT GENITAL PROLAPSE IN COWS | en_US |
dc.sub | Veterinary Surgery | en_US |
dc.subject | VETERINARY SURGERY | en_US |
dc.subject | A STUDY | en_US |
dc.theme | CLINICAL STUDIES ON ETIOPATHOLOGY AND MEDICO SURGICAL MANAGEMENT OF RECURRENT GENITAL PROLAPSE IN COWS | en_US |
dc.these.type | Ph.D | en_US |
dc.title | CLINICAL STUDIES ON ETIOPATHOLOGY AND MEDICO SURGICAL MANAGEMENT OF RECURRENT GENITAL PROLAPSE IN COWS | en_US |
dc.type | Thesis | en_US |
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